AB1451 THE HIP RADIOGRAPHIC SCORE IS CORRELATED WITH THE LATE-ONSET OF JUVENILE IDIOPATHIC ARTHRITIS
Authors: A. Dghaies, H. Ferjani, K. Maatallah, D. Ben Nessib, D. Kaffel, W. Hamdi
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Juvenile idiopathic arthritis (JIA) is a chronic inflammatory disease in children affecting mobility and physical function. The hip is a load-bearing joint and its damage has a significant functional impact. An appropriate scoring system is mandatory to monitor structural progression and damage over time. The childhood Arthritis Radiographic Score of the Hip (CARSH) is a valid score covering the osteoarticular changes in the hip joint as space narrowing, erosions, malalignment, sclerosis, flattening of the femoral head, and growth abnormalities [1]. <h3>Objectives</h3> The aim of this study was to assess radiographic changes in the hip joint using the CARSH in children suffering from JIA with hip involvement and to determine the impact of disease factors in this score. <h3>Methods</h3> This cross-sectional study was conducted in the pediatric rheumatology department and included patients with JIA according to the ILAR criteria. We included children with hip involvement defined as the presence of hip pain and/or limping and range motion limitation, and/or abnormal hip findings in pelvic radiography, ultrasound, or MRI. We collected from the recorded data demographics, disease characteristics [symptom duration, disease presentation, JIA subtypes], and disease activity: Juvenile arthritis disease activity (JADAS10). Experimented and blinded pediatric rheumatologists read the pelvic radiograph using the Childhood Arthritis Radiographic Score of the Hip (CARSH). <h3>Results</h3> Twenty-two children with a mean age of 13 years [5-22] were included in the study. The gender ratio was 1.4 (13 Males/9 Females). The median age of disease onset was 9.5 years [4-14]. The mean duration of the disease was 47 months [4-156]. The diagnostic delay median was 22 months [1-120]. The patient global assessment (PGA) median was 4 [0-8]. The visual analog scale (VAS) median was 3.6 [0-8]. The sedimentation rate (SR) and the C reactive protein (CRP) median were 25 [2-65] and 10 [1-47]; respectively. The JADAS median was 6 [0-18]. Forty-four hips were analyzed. The median score of CARSH was 1.8 [0-7]. The CARSH was positively correlated to the age of disease onset (r = 0.4; p = 0.04). No other significant correlations were found between the CARSH and the gender (p= 0.3), the duration of the disease (r = 0.7; p = 0.7), the diagnostic delay (r = 0.02; p = 0.9), the PGA (r = 0.1; p = 0.5), the VAS (r = -0.4; p = 0.8), the ESR (r = -0.08; p = 0.7), the CRP (r = -0.1; p = 0.6) and the JADAS 10 (r = 0.01; p = 0.9). <h3>Conclusion</h3> This study showed that the radiographic score CARSH was correlated to the age of disease onset. Our findings confirm that structural damage was more important in late-onset disease whereas early hip involvement affects growth and joint development. <h3>Reference</h3> [1] Bertamino M, Rossi F, Pistorio A, et al. Development and initial validation of a radiographic scoring system for the hip in juvenile idiopathic arthritis. <i>J Rheumatol</i>. 2010;37(2):432-439. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.